The Role Of Brain Chemistry And Structure In Schizophrenia
Scientists are looking at possible differences in brain structure and function in people with and people without schizophrenia. In people with schizophrenia, they found that:
- Spaces in the brain, called ventricles, were larger.
- Parts of the brain that deal with memory, known as the medial temporal lobes, were smaller.
- There were fewer connections between brain cells.
People with schizophrenia also tend to have differences in brain chemicals called neurotransmitters. These control communication within the brain.
Studies show that these neurotransmitters are either too active or not active enough in people with schizophrenia.
Doctors also believe the brain loses tissue over time. And imaging tools, like PET scans and MRIs, show that people who have schizophrenia have less âgray matterâ — the part of the brain that contains nerve cells — over time.
Studies of brain tissue in people with schizophrenia after death even show that their brain structure is often different than it was at birth.
Help For Family & Friends
The family and friends of someone with schizophrenia need care and support too its okay for family and friends to prioritise their own mental and physical health while they support someone.
There are many other people out there who share similar experiences, and many services designed to help carers of people with mental health issues. Check out our Guide for Families and Friends for more info.
Effective medical, community, and psychological treatment is available and a person who experiences schizophrenia can live a fulfilling life.
To connect with others who get it, visit our online Forums. Theyre safe, anonymous and available 24/7.
The Warning Signs Of Suicide
The warning signs that people with depression and schizophrenia may be considering suicide include:
- making final arrangements such as giving away possessions, making a will or saying goodbye to friends
- talking about death or suicide this may be a direct statement such as, “I wish I was dead”, or indirect phrases such as, “I think that dead people must be happier than us”, or “Wouldn’t it be nice to go to sleep and never wake up?”
- self-harm such as cutting their arms or legs, or burning themselves with cigarettes
- a sudden lifting of mood this could mean a person has decided to commit suicide and feels better because of their decision
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What Kind Of Symptoms Might People With Schizophrenia Have
People with schizophrenia may have a number of psychotic symptoms. These symptoms can come and go in phases, or they can happen only once or twice in a lifetime. When the illness begins, psychotic symptoms are usually sudden and severe.
During psychotic phases, the person may still understand parts of reality. He or she may lead a somewhat normal life, doing basic activities such as eating, working and getting around. In other cases, the person may be unable to function. Symptoms during psychotic phases include:
- Seeing, hearing, feeling or smelling things that are not real .
- Having strange beliefs that are not based on facts . For example, the person may believe that people can hear his or her thoughts, that he or she is God or the devil, or that people are putting thoughts into his or her head.
- Thinking in a confused way, being unable to make order out of the world, shifting quickly from one thought to the next.
- Having emotions, thoughts and moods that do not fit with events.
People with schizophrenia also may:
- Have a lot of energy or be overly active, or become catatonic, a state in which the body becomes rigid and cannot be moved.
- Talk in sentences that do not make sense.
- Not wash or groom.
- Be very sad or have mood swings.
- Have dulled emotions.
Hope For The Patient And Family
A diagnosis of schizophrenia is life-changing for those affected and everyone who loves them. But, with hard work and dedication, you can help your loved one enjoy a meaningful life.
People with schizophrenia can finish college, work jobs, get married, have families and enjoy a reasonably healthy life, stresses Dr. Bowers.
But it requires a combination of good medication, supportive counseling and being connected to community resources.
The National Alliance on Mental Illness offers support groups for the mentally ill and their families. And organizations like Recovery International and Emotions Anonymous are excellent resources for patients, she says.
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How Is It Treated And Is There A Cure
Schizophrenia isnt curable, but it is often treatable. In a small percentage of cases, people can recover from schizophrenia entirely. However, this isnt a cure because there isnt a way of knowing who will have a relapse of this condition and who wont. Because of that, experts consider those who recover from this condition in remission.
Treating schizophrenia usually involves a combination of medication, therapy and self-management techniques. While therapy alone is often effective for treating most mental health conditions, managing schizophrenia usually requires medication. Early diagnosis and treatment are important because they increase the chances of a better outcome.
What Are The Types Of Schizophrenia
There are different types of schizophrenia. The International Classification of Diseases manual describes them as below.
Paranoid schizophrenia
- Pranks, giggling and health complaints.
- Usually diagnosed in adolescents or young adults.
Catatonic schizophrenia
- Unusual movements, often switching between being very active and very still.
- You may not talk at all.
Simple schizophrenia
- Negative symptoms are prominent early and get worse quickly.
- Positive symptoms are rare.
Undifferentiated schizophrenia
Your diagnosis may have some signs of paranoid, hebephrenic or catatonic schizophrenia, but doesnt obviously fit into one of these types alone.
Residual schizophrenia
This type of schizophrenia is diagnosed in the later stages of schizophrenia. You may be diagnosed with this if you have a history of schizophrenia but only continue to experience negative symptoms.
Other schizophrenia
There are other types of schizophrenia according to the ICD-10, such as.
- Cenesthopathic schizophrenia. This is where people experience unusual bodily sensations.
- Schizophreniform. Schizophreniform disorder is a type of psychotic illness with symptoms similar to those of schizophrenia. But symptoms last for a short period.
Unspecified schizophrenia
Symptoms meet the general conditions for a diagnosis, but do not fit in to any of the above categories.
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What If I Am Not Happy With My Treatment
If you are not happy with your treatment you can:
- talk to your doctor about your treatment options,
- ask for a second opinion,
- get an advocate to help you speak to your doctor,
- contact Patient Advice and Liaison Service and see whether they can help, or
- make a complaint.
There is more information about these options below.
Treatment options
You should first speak to your doctor about your treatment. Explain why you are not happy with it. You could ask what other treatments you could try.
Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. If you are not given this treatment, ask your doctor to explain why it is not suitable for you.
Second opinion
A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis.
You dont have a right to a second opinion. But your doctor should listen to your reason for wanting a second opinion.
Advocacy
An advocate is independent from the mental health service. They are free to use. They can be useful if you find it difficult to get your views heard.
There are different types of advocates available. Community advocates can support you to get a health professional to listen to your concerns. And help you to get the treatment that you would like.
The Patient Advice and Liaison Service
Complaints
You can find out more about:
What Causes Schizophrenia And Its Spectrum Of Conditions
Schizophrenia and the related spectrum of conditions dont have a single confirmed cause. Several factors and circumstances increase a persons risk of developing it, but none of them is a guarantee that youll eventually have it.
Experts suspect schizophrenia happens for different reasons. The three main reasons include:
- Imbalances in chemical signals your brain uses for cell-to-cell communication.
- Brain development problems before birth.
- Loss of connections between different areas of your brain.
Risk factors
While there arent any confirmed causes of schizophrenia, there are several factors and circumstances that researchers have connected to the condition.
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How To Treat Schizophrenia
Schizophrenia can be treated with medication and psychotherapy, but it cannot be cured. Medication helps balance the chemicals in your brain that control moods, thoughts, and behavior. Psychotherapy enables you to manage symptoms like hallucinations or delusions by talking about them with a therapist.
Statistical Methods And Measurement Caveats
The prevalence rate of schizophrenia and related psychotic disorders is difficult to estimate using typical household survey methods alone. Accurate assessment of schizophrenia is best achieved using clinicians trained in the diagnosis of mental illnesses. The U.S. prevalence studies cited here were selected based on their use of U.S. population samples and use of methods that involved clinical diagnosis, either via clinical reappraisal studies or clinical record studies.3,4,5
Individuals with schizophrenia and other psychotic disorders may be under-counted in prevalence estimation studies. These individuals may be under-represented in household surveys because they may reside in prisons, other institutions, or may lack a permanent address. Similarly, some people with schizophrenia and other psychotic disorders may not be fully reflected in medical records data because they may not have a documented diagnosis, and/or may receive little or no health care.
Information on statistical methods and measurement caveats can be found in the papers cited on this page and listed in the reference section. Below we provide additional background information for large datasets used in two studies cited on this page.3,5
National Comorbidity Survey Replication
- For more information, see PMID: 15297905.
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What Are The Three Phases Of Schizophrenia
Research has identified schizophrenia to have three phases, these are as follows:
It may sometimes seem as though schizophrenia suddenly develops out of nowhere, this, however, is not the case. There is no such thing as waking up one morning and have bouts of full-blown psychosis. The disease instead consists of psychotic symptoms that slowly start to appear, and the sufferer begins to show a way of thinking that is distorted and has difficulty relating to others.
The phases can be explained accordingly:
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Other Concerns For Men With Schizophrenia
Men with schizophrenia may tend to have lower social functioning and other conditions like substance abuse that complicate their treatment plan and recovery. Dr. Estakhri specializes in both general and addiction psychiatry, so if you have schizophrenia but are also dealing with drug or alcohol abuse, you get the most comprehensive treatment at Allied Psychiatry & Mental Health right here in Orange County, California.
Schizophrenia can be debilitating. Let us help you manage your symptoms and live a better quality of life. Contact us to make an appointment with Dr. Estakhri today.
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The Age Of Onset In Men And Women
Its hard to pinpoint the exact onset of schizophrenia because people may have cognition problems or trouble in social relationships long before they are officially diagnosed. In general, schizophrenia is diagnosed in late adolescence through the early 30s.
Men are usually diagnosed between the late teens and early 20s, with a peak at 21-25 years of age. Women are diagnosed a few years later, at 25-30 or again after menopause.
The ages are just a guide. No matter when you notice any of the signs or symptoms of schizophrenia in yourself or a loved one, its important to get diagnosed and treated as soon as possible. Symptoms include confusion, disorganized speech, and hallucinations .
At Allied Psychiatry & Mental Health, board-certified psychiatrist Dr. Hadi Estakhri helps his patients live better quality lives through symptom management.
What Can I Expect If I Have This Condition
Schizophrenia is a condition where the outlook varies greatly from person to person. People who have schizophrenia tend to struggle with work, relationships and self care. However, with treatment, some are able to work, care for themselves and have fulfilling relationships.
This condition also often affects people in cycles. That means many people with this condition go through periods where the condition flares up and their symptoms get much worse, followed by a period where symptoms improve but they still have some ongoing struggles.
Despite how serious this condition is, treatment does make it possible for people with schizophrenia to live with the condition and minimize how it affects their lives.
How long does schizophrenia last?
Schizophrenia is a lifelong condition. While some people will recover from this condition after having only one or two episodes, schizophrenia symptoms can return unpredictably. People with a history of schizophrenia are in remission as long as symptoms dont return.
Whats the outlook for this condition?
Schizophrenia itself isnt a deadly condition. However, its effects on a person can lead to dangerous or harmful behaviors, to both themselves and the people around them.
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What Medications Or Treatments Are Used
Treating schizophrenia and related conditions typically involves multiple methods. Those methods can happen in combinations or steps.
Medications
There are two main types of medications that treat schizophrenia.
- Typical antipsychotics. Also known as first-generation antipsychotics, these medications block how your brain uses dopamine, a chemical your brain uses for cell-to-cell communication.
- Atypical antipsychotics. These medications, also called second-generation antipsychotics, work differently from first-generation antipsychotics. These block both dopamine and serotonin, two key communication chemicals in your brain. Clozapine is a particularly effective medication that can treat symptoms of schizophrenia when other drugs dont work. However, it has a rare serious side effect that requires frequent blood monitoring to keep people safe, which is why healthcare providers usually recommend other antipsychotics first.
There are other medications your healthcare provider might also prescribe to treat other symptoms that happen alongside or because of your schizophrenia symptoms. They might also prescribe medications to help reduce side effects of antipsychotic medications such as tremors.
In general, your healthcare provider is the best person to talk to about the medications they might prescribe. They can give you more specific information related to your specific situation, including your life circumstances, medical history and personal preferences.
Psychotherapy
Psychosocial Factors During Pregnancy And Delivery
Some studies suggest an association between antenatal stress and schizophrenia. The children of mothers whose husband died while they were pregnant have been found to have a significantly increased rate of schizophrenia compared with children who lost their father in infancy in the first year of life. In The Netherlands, rates of schizophrenia have been found to be very slightly higher in individuals exposed in utero to war and flood disaster than in reference subjects.
In the Northern Finland 1966 Birth Cohort the risk of later schizophrenia among unwanted children was elevated 2.4-fold compared with wanted or mistimed children, even after adjustment for confounding by sociodemographic, pregnancy and perinatal variables. Unwantedness might be a marker for features associated with risk in either the mother or the child. In the same cohort, the level of schizophrenia in the offspring of antenatally depressed mothers was elevated by a factor of 1.5-foldly, but the association was not statistically significant. Those mothers of schizophrenia patients with a psychotic first-degree relative had suffered from depressed mood during pregnancy twice as often as other mothers. The familial risk for psychosis, including genetic risk for psychosis, might explain the elevated prevalence of depressed mood during pregnancy among the mothers of the offspring who went on to develop schizophrenia.
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When To Call A Doctor
If you notice symptoms like these, your teen needs to be checked by a doctor right away. Thats especially true if anyone on either side of their family has had schizophrenia.
The doctor will ask your teen questions about their thinking and behavior, possibly perform a brief physical exam, and give them blood or urine tests to make sure there isnt another medical condition or drug abuse problem thatâs to blame.
For a schizophrenia diagnosis, the symptoms have to last for at least 6 months and donât seem to be due to another medical or psychiatric condition. Sometimes it takes longer than 6 months to make a confident diagnosis, based on how symptoms appear over time.
Your family doctor can refer you to a psychiatrist who works with teens. A psychiatrist has special training in how to diagnose and treat schizophrenia.
If your teen has the condition, a combination of treatments may work best. These might include medication and individual and family therapy.
The diagnosis can be tough news to hear. But with the right treatment, people with schizophrenia do go to college, hold jobs, and have a family life.
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First Episode Of Psychosis
The first episode of psychosis refers to when you first show signs of being unable to distinguish whats real from what isnt. It typically involves hallucinations and delusions, which can seem very real to the person experiencing them.
Experts say the average age at which people first experience psychosis is 24 years old. The oldest age of onset was 63 years and the youngest age was 3 years.
Acting quickly to connect yourself or your loved one with the right treatment during early psychosis can help dramatically. If you are a family member or friend, consider reaching out to a healthcare professional on behalf of the person you care about.
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